Systems and methods for patient communications in conjunction with prescription medications

ABSTRACT

Systems and methods for providing targeted content to a patient who has received a prescription for medication. The systems and methods generally provide the content prior to the Point of Sale (POS) of the actual prescription allow patients to review the content and possibly act on it prior to actually obtaining the medication. Depending on embodiment, the content may be provided by a pharmacy at or around the time of dispensing or by a physician at or around the time of prescribing.

CROSS REFERENCE TO RELATED APPLICATION(S)

This application is a Continuation of U.S. patent application Ser. No.11/222,699 filed Sep. 9, 2005 and now abandoned which in turn claims thebenefit of U.S. Provisional Patent Application Ser. No. 60/608,587 filedSep. 10, 2004, the entire disclosure of which is herein incorporated byreference.

BACKGROUND

1. Field of the Invention

This disclosure relates to systems for providing content to patients whohave been prescribed medications, specifically to systems which canprovide content at or prior to the point of dispensing of the medicationand may provide ongoing dialogue between a patient and a medicationprovider.

2. Description of the Related Art

Advances in pharmaceuticals in recent times have led to the effectivetreatment for many disorders which only a few years ago had no availabletreatment. While these medications can be invaluable to those who needthem, they can also be difficult to use correctly and may be benefitedin their efficacy by other changes in a patient's lifestyle outside thecontrol of their physician. Many medications today are not single dosewonder drugs, but require adherence to a schedule of medication andlifestyle adjustment to be most effective. Sometimes these schedulesrequire a patient to follow complex usage instructions with multiplemedications taken at regular time intervals.

One of the biggest problems with the use of modern pharmaceuticals is tomake sure that the patient uses them correctly so that they are safe andeffective. Further, a patient often needs to be educated that themedication may not solve the underlying problem without the patientmaking more fundamental changes to their lifestyle. After a medicationis dispensed, neither a pharmacist, physician, or pharmaceuticalmanufacturer has much control over the actions of a patient andincorrect use of the medication can not only result in ineffectivetreatment, but a condition becoming resistant to a medication. Themisuse of medications can arise from a variety of causes ranging frompersons being unable to maintain a medication's prescribed schedule, topurposefully taking smaller doses to make medications last longer, topeople simply misunderstanding complicated usage instructions, tomedications lacking efficacy and requiring adjunct or alternatemedications, to medications being resold on secondary markets orotherwise abused.

To deal with these and other problems, pharmaceutical manufacturers andphysicians have been trying to provide better information to patients sothat patients understand how the medications need to be used to be mosteffective and how their therapies can be managed most effectively.Further, there is a recognition in the medical community that amedication may not be a “magic bullet” to solve a condition, but may bean aid, that when combined with lifestyle changes, can get a patient torecover from the condition quicker, or can make it easier for them tolive with the condition.

The provision of information to the ultimate patient of the medicationhas proven to be a problematic issue, however. Often medicationinformation is confusing and difficult to read. Further, informationalpackets provided to a doctor or pharmacist by a pharmaceuticalmanufacturer to be provided to a patient may be misplaced or not givenout correctly. Further, recently both pharmacists and physicians havebeen subjected to decreased reimbursements from insurance companies andother payors for their services. This has resulted in their need toincrease the volume of cases they handle to maintain profits at afunctional level, which has, in turn, resulted in them being unable tospend as much time with each patient and therefore less time discussinginformation related to indicated medications with patients. For thesereasons, among others, it is desirable to provide information in a formwhere there is little chance for human forgetfulness in providing theinformation with the medication whenever possible, and in a form thatallows pharmacists and physicians to provide more information in lesstime by providing information that the patient can study at home or atanother convenient time.

Another issue related to modern medication is the increase in genericsand competitive brands and the need for original medicationmanufacturers to brand a medication and build customer loyalty to beable to recoup research and development expenses. Modern medications canrequire a massive investment for research and development as well aslarge investments for production and distribution. Further, educationalprograms for physicians to instruct them in how to provide themedication to appropriate patients also require a large investment bythe medication manufacturer. These costs are generally intended to bemade up by medication sales. However, if another brand enters the marketwhich is able to maintain lower costs by utilizing the investmentalready made by the first medication company, the original innovator maybe unable to effectively compete leading to there being less developmentas investments cannot be returned.

Medication companies can attempt to recoup investments by patentingmedications, but also will utilize branding to try and distinguish theirproduct from other competitive products. Branding with trademarks is awell recognized process in all facets of goods. However, brandingrequires investments in advertising to bring the brand to the awarenessof the consumer. Further, most pharmaceutical companies do not have asingle brand, but utilize many brands. Building customer loyalty toproducts can also help to offset costs by having a pharmaceuticalconsumer not only purchase a particular product from the manufacturer,but to also purchase other products that s/he may need as well.

Provision of information related to the drug can be beneficial ifprovided at the pharmacy. Such benefits can also carry over intoover-the-counter (OTC) medications. OTC products can be useful, orharmful, in combination with prescription drugs, and, in some cases, inplace of prescription drugs. OTC products can also be useful in treatingside effects from prescription drug use.

In order to provide usage and other information to medication consumersregarding both prescription and OTC products at the pharmacy, manypharmacies have adopted systems for providing pharmacy informationsheets such as those described in U.S. Pat. Nos. 6,240,394 and6,067,524, the entire disclosures of which are herein incorporated byreference, to use with the distribution of medications. The problem withthese systems, however, is that they are cumbersome to pharmacists andrequire the inclusion of significant additional computer hardware whichtakes up space at the pharmacy. Further, these “add-on” systems canbreak down leaving the systems non-functional until service techniciansoutside the pharmacy come in and repair or replace them. Further, thesesystems impose capital expenses, increased maintenance, and otherproblems on those providing the pharmacy information sheets whichnecessarily increases the costs of providing the services. The systemsare generally redundant between pharmacies and are operationallyinefficient as the systems rely on mechanisms which provide forunnecessary complexity.

The systems also only provide information at the point of sale of themedication. This is often too late as by the time the patient willreview the material they have left the pharmacy and already own themedication.

SUMMARY

Because of these and other problems in the art, discussed herein aresystems and methods for providing targeted material to a prescriptionmedication patient which do not require significant hardware investmentand provide for streamlined provision of material in a way which is moretransparent to the pharmaceutical provider. The systems may also provideinformation to the patient prior to the patient leaving the pharmacy orphysician's office with the medication. In this way, the patient willoften be both a captive audience for the information and will have readyaccess to a physician or pharmacist who can answer any questions thatmay arise from the content.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 Provides a block diagram of an embodiment of a patientcommunication system utilizing information provision at a pharmacy.

FIG. 2 Provides a flowchart of steps in an operation of the embodimentof FIG. 1.

FIG. 3 Provides a block diagram of an embodiment of a patientcommunication system utilizing information provision via an Internetpharmacy prescription request.

FIG. 4 Provides a flowchart of steps in an operation of the embodimentof FIG. 3.

FIG. 5 Provides a block diagram of an embodiment of a patientcommunication system utilizing information provision in a medicalprovider's (physician's) office.

FIG. 6 Provides a flowchart of steps in an operation of the embodimentof FIG. 5.

FIG. 7 Provides a block diagram of an embodiment of a patientcommunication system utilizing information provision from an electronicprescribing provider.

FIG. 8 Provides a flowchart of steps in an operation of the embodimentof FIG. 7.

FIG. 9 Provides a block diagram of an embodiment of a patientcommunication system utilizing information provision from an electronicprescribing provider.

FIG. 10 Provides a flowchart of steps in an operation of the embodimentof FIG. 9.

FIG. 11 Provides a block diagram of an embodiment of a patientcommunication system which utilizes content “push” to an electronicprescribing provider.

FIG. 12 Provides a flowchart of steps in an operation of FIG. 11.

FIG. 13 Provides a block diagram of an embodiment of the invention forongoing direct dialogue with the patient.

FIG. 14 Provides an embodiment of printed content which may be providedto a patient.

DESCRIPTION OF PREFERRED EMBODIMENT(S)

The systems and methods discussed herein are principally designed forproviding targeted material to a prescription medication patient priorto their obtaining the actual medication and in an embodiment, as partof an ongoing dialogue with the patient. This material is generallygeared specifically to the patient, their condition, and the medicationsthey have been prescribed and can, among other things, help to provideinformation about a particular medication brand, provide informationabout related products made by a similar company whether prescription orover-the-counter (OTC), provide for additional patient information,provide information about or promote an adjunct application for amedication, or provide for suggestions or reminders of actions to beperformed by the patient to improve medication efficacy such as, but notlimited to, lifestyle changes. This material, regardless of type, isgenerally referred to herein as “content.” Content is intended, in anembodiment, to provide for an effective dialogue to the patient atvarious stages of medication use. The content may be provided by anyparty involved in any way with the medication or system.

A “patient” as discussed herein will specifically refer to an individualwho has been, or will be, prescribed a particular prescriptionmedication for their, or another's, use. The patient may not haveactually obtained or taken the prescription medication before, or may bea regular patient of the medication. The patient will, however, havebeen, or will soon be, prescribed the medication as treatment for aparticular condition which the patient is presumed to have. It should berecognized, however, that in an embodiment, the patient may not have thecondition or may be attempting to obtain unauthorized medicationsthrough a falsified prescription or similar contrivance.

The “medication” will generally be presumed to be a pharmaceutical drugavailable by prescription. However, the medication is not limited todrugs but can include other items such as, but not limited to,supplements, ointments, placebos, devices, or any other materialsavailable by prescription. Therefore, the term “medication” is usedbroadly to refer to objects which are prescribed or otherwise indicatedfor use by the patient in treatment of the condition.

The patient will generally interact with two individuals during theprescription process. The first of these will be the individual whoassigns the prescription to the patient. This individual will bereferred to herein as a “physician”; however, one of ordinary skill inthe art would recognize that this term is not intended to be limited todoctors, but could encompass any individual who is able to prescribe anymedications. Further, tasks discussed herein as being performed by aphysician could also be performed by any member of a physician's staffauthorized to perform that action. This could include but is not limitedto, a nurse, a physician's assistant, a technician, an intern, aresident, a medical student, a secretary, or any other individual taskedby the physician to carry out the action. These individuals are all,therefore, included within the definition of physician for the purposesof this disclosure.

The second individual is the one who dispenses the prescription orotherwise physically prepares the medication to be provided to thepatient. This person is referred to herein as the “pharmacist.” Again,it should be recognized that the term is not limited to those who arelicensed pharmacists but to anyone who can legally fill a prescription.Again, tasks discussed herein as being performed by a pharmacist couldalso be performed by any member of a pharmacist's staff authorized toperform that action. This could include but is not limited to, atechnician, an intern, a pharmaceutical student, a secretary, or anyother individual tasked by the pharmacist to carry out the action. Theseindividuals are all, therefore, included within the definition ofpharmacist for the purposes of this disclosure. It should also berecognized that in some cases the physician and the pharmacist may bethe same person.

The system has two principle points of contact with the patientdepending on the embodiment. In some embodiments, the system utilizesthe patient's contact with the pharmacist dispensing the medication inaccordance with the prescription as the point of contact. Otherembodiments utilize the patient's contact with the physician providingthe prescription as the point of contact. Still further embodimentsutilize both these points of contact as well as direct contact. Anyembodiment may also utilize ongoing dialogue with the patient outside oftheir contact with either the physician or pharmacist as an additionalpoint of contact.

The embodiment of FIG. 1 is designed so content is provided at the pointof medication dispensing (at the pharmacy). It, therefore, is generallyintended to provide the content at a pharmacy location so that theinformation may be provided to the patient in conjunction with thephysical medication also being provided at the same location. Supplyinginformation at this time is beneficial as the patient will be providedwith the physical medication and the content in close proximity to eachother which places the two items together and makes it harder for thepatient to misplace the content later. They will preferably be providedwith the content prior to actually getting the medication so that theycan review it while waiting for the medication to be prepared.

In this embodiment, the layout comprises a pharmacy computer (101) whichis under the control of the pharmacist dispensing the medication. Thepharmacy computer (101) will generally be a computer previously in useby the pharmacist for preparing prescriptions and will include softwarefor preparing and filling prescriptions. This software may be designedto provide for clinical review of medications, to provide for necessaryrecord keeping for pharmacy transactions, may provide for the printingof pharmacy container labels, or any other functionality commonly in apharmacy computer (101) of the prior art.

The pharmacy computer (101) will also include hardware and/or softwareallowing access to the Internet (102) or other network by any mechanismcurrently known or later discovered including, but not limited to,through a modem and phone line, a Digital Subscriber Line (DSL)connection, a cable modem, a T1 or T10 high speed connection, a wirelessconnection, or any other connection. Generally, Internet (102) servicewill be provided by an Internet Service Provider (ISP). Thiscommunication software and hardware may be provided standard with thepharmacy computer (101), may have been added for other reasons, or maybe provided as part of an embodiment of the system for providingcontent.

Throughout this disclosure, the term “computer” will be used to describehardware which implements functionality of various systems. The term“computer” is not intended to be limited to any type of computing devicebut is intended to be inclusive of all computational devices including,but not limited to, processing devices or processors, personalcomputers, work stations, servers, clients, portable computers, and handheld computers. Further, each computer discussed herein is necessarilyan abstraction of a single machine. It is known to those of ordinaryskill in the art that the functionality of any single computer may bespread across a number of individual machines. Therefore, a computer, asused herein, can refer both to a single standalone machine, or to anumber of integrated (e.g. networked) machines which work together toperform the actions. In this way the functionality of a pharmacycomputer may be at a single computer, or may be a pharmacy networkwhereby the functions are distributed. Further, the term “software”refers to code objects, logic, or command structures, written in anylanguage and executable in any environment designed to be executed by oron a computer. It should be recognized that software functionality canbe hardwired onto a chip or into other hardware while still consideringit software within the meaning of this disclosure.

In order to provide for the content, the pharmacy computer (101) willhave additional software installed thereon to carry out the arrangementand transfer of information with a remote auxiliary computer (103) asdiscussed below. This software, which is called the “content requestingsoftware” will preferably be entirely contained on the pharmacy computer(101) and will operate to form the first data structure, transmit thefirst data structure to the auxiliary computer (103), receive a seconddata structure from the auxiliary computer (103), and transmit contentto a pharmacy printer (109).

The content requesting software will preferably be installed on a harddrive or other memory device associated with or accessible by thepharmacy computer (101) so that the content requesting software can beexecuted by the pharmacy computer (101). It is preferred that thecontent requesting software be operable in a standard operatingenvironment (such as, but not limited to, Windows™, MacOS™, Unix™, orLinux™-based operating systems) and it is more preferred that thecontent requesting software be able to operate in conjunction with, andbe integrated into, the software previously on the pharmacy computer(101) for carrying out prior art pharmacy transactions. In anembodiment, the content requesting software is designed to integratewith the software for pharmacy functions and may be considered a plug-inor upgrade to the software previously provided for pharmacy functions.In an embodiment, the content requesting software will operateautonomously or semi-autonomously requiring little or no additionalinput from the pharmacist in order to carry out its functions. In thisway it operates relatively transparently to the pharmacist.

It should be recognized that the content requesting software ispreferably integrated with the operation of the pharmacy computer (101)in the performance of the pharmacy computer's prior tasks at thepharmacy. The content requesting software does not comprise any type ofexternal “capture” system using output generated by the pharmacycomputer (101), but instead operates as a part of the pharmacycomputer's (101) operation and on the pharmacy computer (101) tointegrate with existing functionality.

The system also comprises an auxiliary computer (103) located physicallyremote from the pharmacy computer (101), specifically not in the actualpharmacy, and not under the control of the pharmacist dispensing theprescription. Preferably, the auxiliary computer (103) will be in aphysically secured location. The auxiliary computer (103) also includeshardware and software allowing access to the Internet (102) by anymechanism currently known or later discovered such as, but not limitedto, a modem and phone line, a Digital Subscriber Line (DSL) connection,a cable modem, a T1 or T10 high speed connection, a wireless connection,or any other connection. The auxiliary computer (103) is generally aserver type of computer capable of receiving and transmittinginformation via a network. In particular, the auxiliary computer (103)includes software designed to receive a first data structure from thepharmacy computer (101) sent by the content requesting software and torespond to that first data structure with a second data structure whichis understood by the content requesting software on the pharmacycomputer (101). This software is called “selection software.”

Generally, a single auxiliary computer (103) will be presumed tocommunicate with a plurality of pharmacy computers (101) via theInternet. However, there may be more than one auxiliary computer (103)configured to communicate with the plurality of pharmacy computers(101). Therefore, the auxiliary computers (103) and pharmacy computers(101) may be arranged in any form of server/client relationship, as thatterm is understood by those of ordinary skill in the art, with theauxiliary computers (103) generally acting as servers and the pharmacycomputers (101) generally acting as clients. The auxiliary computer(103) may be a stand alone machine, or may have access to externalresources such as an external memory or database (107). In anembodiment, multiple auxiliary computers (103) have access to a sharedmemory such as database (107).

The pharmacy computer (101) can transmit information on a patient'sprescription and on the patient to the auxiliary computer (103) via theInternet as a first data structure. The first data structure willgenerally comprise a transmission sent via a standard Internet protocolsuch as hypertext transfer protocol (http) or any other protocol used onthe Internet whether known now or later discovered. The solid line ofFIG. 1 generally shows the path of the first data structure in thisembodiment. The first data structure includes all necessary informationfor use by the auxiliary computer (103) to identify characteristics ofthe dispensing activity which are to be used by the auxiliary computer(103). Upon receipt of the first data structure at the auxiliarycomputer (103), selection software on the auxiliary computer (103) mayuse some or all of the information in the first data structure to selectcontent targeted to the patient. If there is content selected, theauxiliary computer (103) will either send the content to the pharmacycomputer (101) or may send an identifier to identify particular contentstored on the pharmacy computer (101). Whichever is sent, thistransmission comprises a second data structure and is shown by thedashed line in FIG. 1.

There is also a pharmacy printer (109) physically co-located with thepharmacy computer (101), specifically in the pharmacy, and under thecontrol of the pharmacist dispensing the prescription. The pharmacyprinter (109) may be any type of printer capable of rendering paperversions of electronic data and will be used to fulfill any needed printrequests from the pharmacy computer (101). Generally, the pharmacyprinter (109) will be arranged to print vial labels, amongst otherthings, to aid the pharmacy in the dispensing process. The pharmacyprinter (109) will generally be connected to the pharmacy computer (101)by a cable (104) such as, but not limited to, a serial, parallel, orsimilar cable or through a wireless interface such as infrared (IR).Alternatively, the pharmacy printer (109) may be connected to thepharmacy computer (101) via a Local Area Network (LAN) if the pharmacyprinter (109) is shared by multiple pharmacy computers (101) co-locatedwith each other. The content identified by the auxiliary computer (103)in the second data structure, will be sent to the pharmacy printer (109)by the pharmacy computer (101). This transmission will comprise astandard print task between a computer and a printer. The content willbe formatted by the pharmacy computer (101) for printing in accordancewith standard print formatting principles. The pharmacy printer (109)will generally print the content in a single-sided or double-sidedformat on paper provided at the pharmacy printer (109).

The auxiliary computer (103) may also be connected, via the Internet, toa computer or other system capable of receiving information directed toit from the Internet (the patient access computer (301)). This may be acomputer capable of receiving email, automated messaging, or voicetransmissions, or may be another computing or processing device such asa cellular telephone, BlackBerry™ device, or personal digital assistant(PDA) capable of connecting to the Internet or receiving packetizeddata. The patient access computer (301) can be accessed directly by thepatient, generally via a secured connection, and may be accesseddirectly or over a network such as the Internet.

An embodiment of the operation of the embodiment of the system shown inFIG. 1 follows the flowchart of steps shown in FIG. 2. While this orderof steps is intended to be exemplary, it is in no way limiting to theparticular order of steps provided. A patient will generally arrive atthe pharmacy in step (302) to request a prescription be dispensed forwhich they will generally have a written prescription paper from theirphysician. The prescription may alternatively have been electronicallytransmitted to the pharmacy by the physician. This may be a new orrenewed prescription. Alternatively, the patient may be picking up arefill of a prescription already in possession of the pharmacist. Inthis case, the patient will not provide the prescription, but will haveidentified themselves to the pharmacist and the pharmacist will confirmthat that patient has an available refill already on record at thepharmacy.

Regardless of the method that the prescription is provided to thepharmacy, the pharmacist will enter the information from theprescription into the pharmacy computer (101) in step (303) if it hasnot already been so provided. The pharmacy computer (101), once providedwith the prescription information, will carry out any manipulations onthat information as it normally would and will generally store thatinformation to an associated memory.

The entered information will generally include any or all of, but is notlimited to: The National Drug Code (NDC) for the prescription, thepatient's age, patient's gender, patient ID (such as a name and/oridentifying number), patient contact information, physician identifier,prior patient behavioral data, whether it is a new or refilledprescription, or any other information of the type traditionally enteredby a pharmacist in preparation for dispensing a prescription. There alsomay be information gathered which is not normally collected but isavailable to the pharmacist from the patient and useful in selectingcontent.

Once the information is entered, the pharmacy computer (101) willperform its normal actions to allow the pharmacist to fill theprescription. In addition, the content requesting software on thepharmacy computer (101) will perform additional steps to provide forselection of the content. In particular, the content requesting softwarewill gather data from the information entered as a part of this pharmacytransaction and encrypt in step (305) some or all of the data gathered,and possibly other information already on the pharmacy computer (101)such as, but not limited to, the name of the pharmacy, the address ofthe pharmacy, and the store number of the pharmacy, and transmit theencrypted information in step (307) as a first data structure to theauxiliary computer (103) over the Internet. Encryption need not be usedin an alternative embodiment. However, as the information sent wouldgenerally be considered to be confidential, it is preferred that asecure encryption method be used to prevent eavesdropping.

When the first data structure is received by the auxiliary computer(103), the auxiliary computer (103) in step (309) will confirm that theinformation received is without errors in transmission as is understoodby those of ordinary skill in the art. If the receipt is not confirmed,the auxiliary computer (103) will request resending of the informationin step (311). If the information is confirmed to be received, theauxiliary computer is step (313) will decrypt the first data structureand may then store some or all of the information therein in anassociated memory or database (107). The database (107) may be eitherlocal on the auxiliary computer (107) such as an associated hard driveor may be located remotely such as on a network depending on thearrangement of the auxiliary computer (103). The database (107) mayinclude other information about this patient received from priortransactions about this patient with the pharmacy computer (101) or withother pharmacy computers or other systems in communication with theauxiliary computer (103).

Based on the new information provided from the first data structure,possibly in conjunction with information already in the database (107),the selection software in step (315) will determine whether content orinformation should be provided to the specific patient. The availabilityof content will generally be determined by analyzing the information andany other information the auxiliary computer (103) has available on thepatient to look for particular patterns or entries based on apredetermined set of search criteria located at the auxiliary computer(103). This may be a result of any pattern and content may be selectedbased on any number of pieces of information as specified by theselection software running on the auxiliary computer (103).

Once the selection software determines in step (315) if a particularpattern or entry exists which corresponds to particular content beingappropriate for distribution to the patient, the content will beselected by the selection software. The content may be of any form andmay include any information as discussed later.

If no content is available, the auxiliary computer (103) may send backto the pharmacy computer (101), via the Internet, an indicator that nocontent is available as in step (317) or the auxiliary computer (103)may simply do nothing within a prescribed time to indicate that nocontent is available to the pharmacy computer (101). If selectionsoftware determines that content is available, the auxiliary computer(103) may provide, via the Internet connection between the pharmacycomputer (101) and the auxiliary computer (103), a second data structureto the pharmacy computer (101) as shown in step (321). The second datastructure may comprise either the content in a form understandable bythe content requesting software on the pharmacy computer (101) (such as,but not limited to, a file formatted for Microsoft Word™, or AdobeAcrobat™) or instructions to utilize particular content maintained in amemory cache at the pharmacy computer (101) or a third computer incommunication therewith.

When the pharmacy computer (101) receives the second data structure fromthe auxiliary computer (103), the pharmacy computer (101) may alsoperform error checking in a similar fashion to that performed by theauxiliary computer (103) in steps (309) and (311). Once receipt isconfirmed, if the second data structure comprises actual content, thecontent may be printed by the content requesting software, sending it tothe pharmacy printer (109) via the print stream in step (325). If thepharmacy computer (101) receives instructions about the content to beused, the content requesting software may access the content in a localmemory cache at the pharmacy computer (101) or other location accessibleto the pharmacy computer (101) in step (323) and then send the contentto the pharmacy printer (109) in step (325).

Regardless of which method is used for sending content to the pharmacyprinter (109), the pharmacy printer (109), upon receiving the content,will print the content. Preferably, the printing will occur on a singlesheet of standard paper forming an insert or reference sheet. Thecontent may be combined with other information sent to the printer to beprinted such as the medication monograph, receipt, or other counselinginformation provided by the pharmacy computer (101) in the course of anormal pharmacy transaction. The pharmacist will pick up the printedcontent either prior to or while preparing the medication. They mayreview the content, and will then generally place the content with themedication.

Alternatively, the pharmacist can provide the content to the patientwhile they are waiting for the prescription and before they have leftthe pharmacy drop-off window. The entirety of steps in FIG. 2 may beaccomplished in a matter of seconds allowing the content to bedistributed prior to filling the prescription. It should be recognizedthat in either case the content is prepared and provided in response toa request for dispensing of the medication, not the sale of themedication. This provides for content prior to completion of a pharmacytransaction. In most cases, the content will be provided with themedication with both items then being placed behind a counter or similarfor later pickup by the patient or the content will be provided to thepatient while they are waiting for the prescription to be dispensed.When the patient picks up their prescription and pays for it, thecontent will already be present with the medication or previouslyprovided to them, it will not be generated in response to the sale ofthe medication.

This is an important distinction because the point of sale (POS) of themedication is often too late to provide the information. At the POS, thepatient is completing the transaction and if material was to be printed,the patient would be forced to wait for the material to print after (orwhile) paying, which they may or may not choose to do as they havealready obtained their medication and their ability to maintainconfidentiality about the nature of their prescription with a pharmacistmay be lost as a clerk or other employee may actually control the POS.Distributing the content at the point of dispensing provides for thematerial to already be present for review by the patient and pharmacisttogether while maintaining patient privacy (between patient andpharmacist) prior to completion of the sale. This also allows thepatient to review the material before completing the sale which canallow the patient to determine if they would like to purchase additionalproducts based on the content without having to carry out a second salestransaction or if there are concerns which may result in the sale notbeing completed. In the case where content can be provided prior to thepatient commencing their waiting for the prescription, it also providesthe content to the patient when they are at the pharmacy, generally withlittle or nothing to do, and the patient can read the content whilewaiting. Further, if the patient's use of additional non-prescriptionproducts or OTC medications is encouraged by the content, the patientcan locate those products at the pharmacy while waiting, and can utilizeinformation provided with the content in a discussion with thepharmacist without having to return to the pharmacy after obtainingtheir medication.

This arrangement also provides for a single transaction for the patientfor both the medication and other related products whose use may beencouraged by the content, and the ability to have read the content andprepared any questions before purchasing the medication or leaving thepharmacy. These can improve the patient's willingness to follow throughwith the medication, for them to use the medication effectively, and canmake it much easier for them to bring any questions or concerns to thepharmacist's attention at the time they purchase their medication.

FIG. 3 provides a block diagram of another embodiment of a system forproviding information to the patient. In this system, the pharmacist isstill used as the point of contact and the content is still generated atthe point of dispensing; however, the pharmacy is presumed to be remotefrom the user who is connected to it via an Internet transaction. Asimilar embodiment would utilize phone or mail order transactions. Inthe particular embodiment of FIG. 3, the user is connected to anInternet connection and the pharmacy comprises a so-called “Internetpharmacy.” This embodiment is similar to the embodiment of FIG. 1, andthe detail of computers is not repeated due to the similarity. However,in this case, the patient will never actually go to the pharmacy but theprescription will be transmitted electronically, the medication will bedispensed remotely, and it will then, generally be mailed to them.Therefore, the provision of the content does not rely on printing at thepharmacy.

In this embodiment, the system will generally operate in a similarmanner to the embodiment of FIG. 1, however, the information used toselect content may be obtained directly from the patient as well as fromthe e-pharmacy computer (401). In particular, to transmit theprescription request to the e-pharmacy for dispensing, the patient willgenerally enter order information into a patient computer (311). Theprescription information may be on the e-pharmacy computer (401) or maybe provided to the e-pharmacy computer (401) by the patient (generallyby mail) or directly from the physician or physician's electronicprescribing provider. This order information can be received by thecontent requesting software which will generally be running on thee-pharmacy's computer (401) which will receive the order. This is shownby the long dash short dash line in FIG. 3. Upon receipt, the contentrequesting software can send the first data structure to the auxiliarycomputer (103) in the same manner as it would from the standardbrick-and-mortar pharmacy computer (101). The auxiliary computer (103)can then contact the patient computer (311) directly via the Internet,providing the content via email screen pops or another form as soon asthe prescription is transmitted from the patient.

An embodiment of the operation of the embodiment of the system shown inFIG. 3 follows the flowchart of steps shown in FIG. 4. Once again, whilethis order of steps is intended to be exemplary, it is in no waylimiting to the particular order of steps provided. In step (600) thephysician or patient sends the prescription to the e-pharmacy such asby, but not limited to, fax, email, or mail. The patient in step (602)will electronically transmit information necessary to enable thee-pharmacy to dispense the prescription to the e-pharmacy computer (401)using standard electronic transmission mechanisms such as email or byfilling out an online form. This information will be received by thee-pharmacy computer (401) in step (603). The e-pharmacy computer (401),once provided with the prescription information, will carry out anymanipulations on that information as it normally would and willgenerally store that information to an associated memory.

The entered information may include any or all of the informationprovided in the embodiment of FIGS. 1 and 2. Once the information isreceived, the e-pharmacy computer (401) will perform its normal actionsto allow filling of the prescription. In addition, the contentrequesting software on the e-pharmacy computer (401) will performadditional steps to provide for selection of the content. In particular,the content requesting software will gather data from the informationentered as a part of this pharmacy transaction and encrypt in step (605)some or all of the data gathered, and possibly other information alreadyon the e-pharmacy computer (401) such as, but not limited to, the nameof the pharmacy, and transmit the encrypted information in step (607) asa first data structure to the auxiliary computer (103) over theInternet. Encryption need not be used in an alternative embodiment.However, as the information sent would generally be considered to beconfidential, it is preferred that a secure encryption method be used toprevent eavesdropping. Again, the first data structure transmission isshown by the solid lines.

When the first data structure is received by the auxiliary computer(103), it will perform much the same actions as in the embodiment ofFIG. 2. The auxiliary computer (103) in step (609) will confirm that theinformation received is without errors in transmission as is understoodby those of ordinary skill in the art. If the receipt is not confirmed,the auxiliary computer (103) will request resending of the informationin step (611). If the information is confirmed to be received, theauxiliary computer is step (613) will decrypt the first data structureand may then store some or all of the information therein in anassociated memory or database (107) as disclosed previously.

Based on the new information provided from the first data structure,possibly in conjunction with information already in the database (107),the selection software, as in the previously discussed embodiment, instep (615) will determine whether content or information should beprovided to the specific patient.

Once the auxiliary computer (103) determines in step (615) if aparticular pattern or entry exists which corresponds to particularcontent being appropriate for distribution to the patient. The contentwill be selected by the auxiliary computer (103). The content again maybe of any form and may include any information as discussed later.

If no content is available, the auxiliary computer (103) will generallysimply do nothing. If the auxiliary computer (103) determines thatcontent is available, the auxiliary computer (103) may provide, via theInternet, a second data structure directly to the patient computer (401)as shown in step (621). The second data structure will generallycomprise the content in a form readable by the patient computer (311)(such as, but not limited to, a file formatted for Microsoft Word™, orAdobe Acrobat™ or text sent in hyper-text markup language (HTML) or inanother form readable by the patient). The content may alternatively beincluded as part of an email, or in another form (such as, but notlimited to, an instant message) which should be understandable by thepatient computer (311). The patient may also be provided with a moretraditional printout by mail with the medication by the e-pharmacyprinting the material on a printer (not shown) and sending it with themedication. This printed content may be provided in addition to orinstead of providing the content electronically. The transmission of thesecond data structure is shown as the dashed line in FIG. 3.

Once the patient computer (311) receives the content, the patient willgenerally receive notification that they have received correspondence ofthe type sent or the content may simply be provided to the patient, suchas in a “pop-up” window. The patient may then review the content in step(623). In this embodiment, the content is not provided to thepharmacist, as the pharmacist would generally be unable to provide thecontent prior to sale of the prescription, which, as discussedpreviously, is not as desirable as having content provided before sale.Instead, the system communicates directly with the patient computer(311) so that the patient should have the content shortly aftertransmitting the original prescription request. In this case, thepatient may have the ability to alter their order with the e-pharmacy toprovide for shipment of the prescription plus anything else the patientmay determine they are interested in purchasing based on the content.The direct contact also allows the patient to review the content beforethey obtain the medication so that they are prepared to obtain themedication. The e-pharmacy may also provide electronic shipping to thepatient based on the content to further simplify their ability topurchase additional suggested products.

In the above-described embodiments, the exact form and content of thecontent is generally open and may include any information in any form.The information will generally be intended for consumption by thepatient, but may also include information for use by the pharmacist.Therefore, the content will usually include information likely to be ofuse or interest to the patient and may be intended to affect thepatient's behavior. In an embodiment, the content will includemedication usage reminders or suggested lifestyle indications to makethe medication work more effectively. In an embodiment where theprescription is new, this might include, but is not limited to, startingan exercise program, making a change in diet, or encouraging the patientto stop smoking. Further, the content may also include indicators toencourage the patient to refill the prescription promptly or to keepcareful tabs on the medication as missing a day of medication whilewaiting for a prescription to be filled may cause unintended problemswith the treatment. The embodiment of FIG. 14 includes some examples ofcontent of this type. If consumption of the information is intended forthe pharmacist, the content will generally so indicate. As the materialis provided at the point of dispensing, the pharmacist is thus preparedto discuss the content with the patient when the patient comes topurchase the medication. When geared to the pharmacist, the content mayinclude, but is not limited to, the answers to common concerns about themedication to prepare the pharmacist for questions from the patient, ormay include indications of new uses for, or new risks of, the medicationwhich the pharmacist may not be aware.

In the embodiment discussed above, the prescription is new and there maynot be any need to provide for reminders or admonishments based on priorbehavior of the patient with regards to the prescription. In anotherembodiment, such as when a prescription is being refilled, the contentmay include information related to the patient's extrapolated use of themedication and their possible misuse. The content can also make surethat a patient is advised of risks of misuse. For example, if a patienthad gotten a prior 30-day supply of a medication, and arrived at thepharmacy 45 days after picking up their prior prescription to refill it,the content could include a notice to make sure that the patient istaking the correct dosage of their medication as it appears that themedication was not taken correctly. Further, risks from not using themedication correctly can be provided. Similar content could be providedif the patient picks up two 30 day supplies of two related medicationson the same day, but when they return to refill the prescription onlyrefills one of the two prescriptions. This admonishment could remind thepatient that they need to take both medications on the same schedule forthem to remain effective.

In addition to personalized information related to the patient's use ofthe product and other suggestions to help them to deal with theunderlying condition for which the prescription was prescribed, thepatient can also be supplied with commercial information. The commercialinformation may relate to indications for a name brand medication or mayhelp the patient in the suggested lifestyle changes or in purchasingrelated products they may have need of. This may be particularlyrelevant if the patient filled the prescription with one brand ofmedication when a second brand is available, and may provide informationor encouragement to switch to the second brand name medication over thefirst. This type of product referral is not limited to prescriptionmedications. In an embodiment, there may also be information on otherrelated prescription products which the patient is likely to have needof. For instance, if the patient purchased insulin, there may beinformation provided for diabetic test strips of a particular brand.Alternatively, information for over-the-counter (OTC) medications orsupplements whose use is encouraged in conjunction with the medication(such as those related to the suggested lifestyle changes or to easeside-effects of the prescription medication) may be provided. In a yetfurther embodiment of the invention, the content may include informationfor non-medical products in which the patient may be interested. Forinstance, when a medication is specifically prescribed immediatelyfollowing pregnancy, the content may include information on a particularbrand of diapers.

While the discussion in this case relates specifically to the pharmacistdispensing the prescription being the point of contact which leads tothe content being provided to the patient, the content can also oralternatively be sent to the patient directly if the patient has adevice capable of accessing data from the auxiliary computer (103). Toallow patient access, content may be sent directly to a patient computer(311), but will more commonly be sent to a patient access computer (301)which can be securely accessed by the patient, such as by the Internet,to provide for better indications that the content is confidentialityprovided. This material may be any of the above content, or may becontent which would not be relevant when the patient is in contact withthe pharmacist. In an embodiment of contacting the patient directly, theauxiliary computer (103) may send the patient reminders that theircurrent supply of medication is probably getting low and encouragingthem to renew their prescription with the name brand medication and at asponsoring pharmacy or e-pharmacy. The content may even providesimplified ordering mechanisms for such refill. Further, electronicadvertising may be directly provided as part of this content. Thereminders can become more regular or urgent if it is detected that thepatient may not be using their medication correctly, or may not beintending to refill a specific prescription, and may encouragecontacting their physician. Still further, urgent safety information,such as a product recall, can be communicated directly to the patient ifit is applicable to their medications.

In an embodiment, the system can even be set up to provide reminders forthe patient to be carrying out suggested lifestyle changes along with aschedule that they should be meeting for those changes, helpfulinformation, or encouragement. For instance, if the patient is takingmedications for obesity, a diet schedule may be regularly providedincluding suggested meal recipes that a patient could use to meet atarget caloric intake for a coming week based on their prescribedmedication and dose. These can be very helpful to the patient byproviding more regular health reminders as well as encouragement andinformation to improve the likelihood of making and maintaining alifestyle change. The user could also be directed to an online supportgroup or similar location to help with their diet or provided with aweight monitor which can show them their success.

Such an embodiment of dialogue from the system can even be taken so faras to remind the patient to take their medication according to acomplicated program. Patients with complex medication schedules who havecellular phones, pagers, or other portable communication devices capableof receiving communication from the auxiliary computer (103) or patientswho have regular access to an Internet-connected computer (such as acomputer at work), can receive timed reminders to take medication. Theauxiliary computer (103) can send a message to the patient to takemedication. The messages can be provided on a fixed schedule making iteasier for the patient to remember to take their medication atprescribed times. This can be particularly beneficial to the elderly orthose on very complicated medication regimens. Combined with brandedinformation and helpful additional reminders for upcoming refills andlifestyle changes, the system can provide for a more comprehensivemedication program beneficial to both the supplier of the medication andthe patient.

In particular, this type of ongoing communication, allows for provisionof information to the patient outside of the controlled environment ofthe physician's office and may occur with the patient outside thepharmacy, or in conjunction with a patient's regular pharmacy visits.The patient is provided with both peace of mind and helpful informationrelated to their medication use. At the same time the pharmaceuticalmanufacturer is reassured that product information is being distributedto the correct patients in a timely manner and can gain the benefits ofadvertising to a highly relevant audience.

The above embodiments of the system provide that information is given tothe patient in conjunction with the contact with the pharmacist. In thealternative embodiments depicted in FIGS. 5 through 12, the patient maybe given the content prior to receiving the medication or going to apharmacy to pick the medication up. In these embodiments, the content isprovided around the time the medication is prescribed or at the “pointof prescribing.” In the first embodiment of FIGS. 5 and 6, this priordelivery occurs either at the physician's office when the prescriptionis first issued or renewed, or in intervening time after departing thephysician's office, but before the patient has filled the initialprescription. In the embodiment of FIG. 5, the pharmacy computer (101)is not used to provide for the content selection and instead aphysician's network (200) is used for the initial content selectionessentially being substituted in place of the pharmacy computer (101).The physician's network (200) will generally be a system for providingcomputer support to the physician's office. The system may includepatient scheduling, billing, clinical information, prescriptionservices, or other functions performed at a physician's office.Alternatively, the prescription may be written out, but the physicianmay store the prescription information in the physician's network (200)for records purposes. With regard to content selection, the physician'sserver (201) will generally include content requesting software whichmay be integrated with other software on the physician's server (201).The physician's server (201) will generally have Internet (102) accessof any form as previously discussed and will often allow Internet (102)access to any number of physician's devices (800). A physician's device(800) will generally be some form of computing device acting as a clientto the physician's server (201). This may be a Handheld computer orpersonal digital assistant (803), a laptop computer (801), a desktopcomputer (805), or any other computing device used by the physician thatis in communication with the physician's server (201).

The operation of the system of FIG. 5 preferably follows the flowchartof steps shown in FIG. 6. The physician in step (402) will prepare theprescription for the patient on the physician's device (800) aftermaking a medical determination that such a prescription is appropriate.This may either be a new prescription, or may be additional refills foran existing prescription. To generate the prescription, or simply torecord the prescription for the physician's records, the physician willenter the patient and prescription information into the physician'sdevice (800) in step (403). This entered information may include any orall of, but is not limited to, The National Drug Code (NDC) for aprescription, the patient's age, patient's gender, patient's ID (such asa name or identifying number), patient contact information, physicianidentifier, prior patient behavioral data, whether the prescription isnew or a refill, patient history information, or any other informationof the type that may be of interest to a physician for treating thepatient.

Once the information is entered, the physician's device (800) willtransfer the information to content requesting software on thephysician's server (201) in step (404) as indicated by the long dashshort dash lines in FIG. 5. The physician's server (201) will encrypt,in step (405), some or all of the data entered, and possibly otherinformation already on the physician's server (201) such as, but notlimited to, an identification characteristic of the prescribingphysician, the physician's office location, patient identifierinformation or other information and transmit the encrypted informationin step (407) as the first data structure to the auxiliary computer(103) over the Internet. This is the solid line in FIG. 5. As in thepharmacy computer (101) transaction, encryption need not be used in analternative embodiment.

When the first data structure is received by the auxiliary computer(103), it will be treated in a similar fashion to the previouslydiscussed embodiments. The selection software in step (409) will confirmthat the first data structure is received without errors in transmissionrequesting a resend in step (411) if there are errors. Once the firstdata structure is confirmed to be correctly received, the auxiliarycomputer (103) in step (413) will decrypt the information in the firstdata structure and may then store it in an associated memory or database(107).

Based on the new information provided from the first data structure,possibly in conjunction with information already in the database (107),the auxiliary computer (103) in step (415) will determine whethercontent or information should be provided to the specific patient.Again, the availability of content will generally be determined byanalyzing the information and any other information already available tothe auxiliary computer (103) to look for particular patterns or entriesbased on a predetermined set of criteria.

The selection software on the auxiliary computer (103) will determine instep (415) if a particular pattern or entry exists which corresponds toparticular content being appropriate for distribution to the patient. Ifsuch content exists, the content will be selected by the auxiliarycomputer (103). If no content is available, the auxiliary computer (103)may send back to the physician's server (201), via the Internet, anindicator that no content is available in step (417) or the auxiliarycomputer (103) may simply do nothing within a prescribed time toindicate that no content is available to the physician's server (201).If the selection software determines that content is available, theauxiliary computer (103) may provide, via the Internet connectionbetween the physician's server (201) and the auxiliary computer (103), asecond data structure as shown in step (421) and indicated by the dashedline in FIG. 5. As in the embodiment of FIG. 2, the second datastructure may comprise either the content in a form useable by thephysician's server (201) or instructions to utilize particular contentmaintained in a memory cache at the physician's server (201) or aphysician's device (800). The auxiliary computer (103) may also oralternatively send the second data structure directly to the patientaccess computer (301) as discussed elsewhere.

When the physician's server (201) receives the second data structurefrom the auxiliary computer (103), if the second data structurecomprises actual content, the content may be sent to the associatedprinter (219) via the print stream for printing in step (425) or anassociated physician's device (800) in step (423). If the physician'sserver (201) receives instructions about the content to be used, thecontent requesting software on the physician's server (201) may accessthe content in a local memory cache in step (421) and then send thecontent to the associated printer (219) in step (425) or a physician'sdevice (800) in step (423). Alternatively, content on the physician'sdevice can be accessed in step (423) if that is where the content isstored. Printing of the content will generally be of a similar form tothe printing at the pharmacy printer (109).

In another embodiment where the point of contact is the physician, thesystem may be arranged to utilize an electronic prescribing providercomputer (901) as shown in FIGS. 7 through 12. As opposed to thee-pharmacy computer (401), electronic prescribing provider computer(901) does not generally provide medications, but instead is an aid tophysicians in writing the prescriptions. FIGS. 7, 9, and 11 provide forthree different embodiments of a system using an electronic prescribingprovider computer (901). In these systems, the physician's device (800)is connected to the physician's server (201) forming a physician'snetwork (200) in similar fashion to that previously discussed, which isin turn in communication with an electronic prescribing providercomputer (901) generally via a network structure which may be theInternet (102). The electronic prescribing provider computer (901) willgenerally provide for systems and methods to assist the physician'sgeneration of the prescription by allowing the generation of a“electronic prescription” such as by the physician entering theprescription on the physician's electronic device (800) instead of onpaper. The electronic prescribing provider computer (901) then canprovide the physician with the ability to print a copy of theprescription for the patient, or can fax, email, or otherwise transmitthe prescription to the patient or directly to the pharmacy. Theelectronic prescribing provider may be a provider that only provides theservices of an electronic prescribing provider, as are understood bythose of ordinary skill in the art, or may provide a number of serviceswhich may include e-prescribing capability. In such a situation, theelectronic prescribing provider computer (901) may provide for some orall of the functionality of the physician's server (201) discussed inconjunction with FIG. 5, may provide only specific functionality relatedto prescriptions, or may provide much broader functionality related tothe operation of the physician's practice. The electronic prescribingprovider computer (901) is therefore not limited to an e-prescriber, butmay more generally provide for services to the physician. Further, anelectronic prescribing computer (901) may utilize a third party pharmacyclearinghouse or other similar type of service in its operation. Suchclearinghouse providing additional functionality to the electronicprescribing computer (901).

In the embodiment of FIG. 7, the system may work as shown in theflowchart of steps in FIG. 8. The physician in step (1002) will preparethe prescription for the patient after making a medical determinationthat such a prescription is appropriate. To generate the prescription,the physician will enter the patient and/or prescription informationinto the physician's device (800) in step (1003). The physician's device(800) transfers the information to the physician's server (201) in step(1004).

Once the information is entered, the physician's server (201) willtransmit in step (1005) some or all of the data entered to theelectronic prescribing provider computer (901) in accordance with theknown operation of an electronic prescribing provider computer (901).This is shown by the dotted line in FIG. 7. Upon receipt of theinformation at the electronic prescribing provider computer (901), theelectronic prescribing provider computer (901) will perform its usualoperation to prepare and organize the electronic prescription. Thecontent requesting software, which will generally be running on theelectronic prescribing provider computer (901), will take theinformation received (and possibly information already available to theelectronic prescribing provider computer (901)), and repackage it intothe first data structure which it will send to the auxiliary computer(103) as shown by the solid line in FIG. 7. As discussed in conjunctionwith prior embodiments, the auxiliary computer (103) in step (1009) willconfirm that the first data structure is received without errors intransmission requesting a resend in step (1011) if there is a problem.Once the first data structure is correctly received, the auxiliarycomputer (103) in step (1013) will decrypt the information in the firstdata structure and may then store it in an associated memory or database(107) as discussed previously.

Based on the new information provided from the first data structure,possibly in conjunction with information already in the database (107),the selection software on the auxiliary computer (103) in step (1015)will determine whether content or information should be provided to thespecific patient. Again, the availability of content will generally bedetermined by analyzing the information and any other informationalready available to the auxiliary computer (103) to look for particularpatterns or entries based on a predetermined set of criteria. If nocontent is available the auxiliary computer (103) will so indicate instep (1017).

If such content exists, the content will be selected by the selectionsoftware. If the selection software determines that content isavailable, the auxiliary computer (103) may provide in step (1021), viathe Internet connection between the electronic prescribing providercomputer (901), physician's server (201), and/or the auxiliary computer(103), a second data structure. As discussed in prior embodiments, thesecond data structure may comprise the content in a form useable by acomputer or instructions to use particular content maintained in thememory cache of any of the electronic prescribing provider computer(901) the physician's server (201), or physician's device (800). Thesecond data structure path is indicated by the various dashed lines inFIG. 7. The electronic prescribing provider computer (901) may also oralternatively receive the second data structure. If the second datastructure comprises content or instructions to use content on theelectronic prescribing provider computer (901), the content may beforwarded by the electronic prescribing provider computer (901) to thephysician's server (201) or printer (219) which may in turn pass thecontent to the physician's device (800) for the physician's review oraction in step (1022). The physician will generally then pass thecontent to the patient in step (1024). The auxiliary computer (103)and/or electronic prescribing provider computer (901) may also oralternatively transmit the content directly to the patient accesscomputer (301) in step (1022) depending on embodiment and as discussedelsewhere.

In the embodiments of FIGS. 9 through 12 a similar operation to theembodiment of FIGS. 7 and 8 is performed, except that in theseembodiments, the selection software, which in prior embodiments wasdiscussed as being located on the auxiliary computer (103) and separatefrom the content requesting software, is located on the electronicprescribing provider computer (901) instead and may be combined with thecontent requesting software or the content. In the embodiment of FIGS. 9and 10, the physician will generally prepare the prescription in step(1102), enter the prescription in their device (800) in step (1103)which transfers the prescription to the physician's server (201) in step(1104) and to the electronic prescribing provider computer (901) in step(1105). This is similar to the steps of the embodiment of FIG. 8.Content will generally be provided by the auxiliary computer (103). Theparticular piece of content is selected by the electronic prescribingprovider computer (901) in step (1106) and then requested to betransmitted from the auxiliary server (103) in step (1108). This contentmay be sent to the electronic prescribing provider computer (901) instep (1110) to be passed to the physician's device (800), physician'sserver (201), or printer (219) in steps (1114) and (1116) or again maybe sent directly to the patient access computer (301) in step (1112). Ineffect, the first data structure traveling to the auxiliary computer(103) is eliminated, and a new data structure comprising a request forparticular content is sent to the auxiliary computer (103) whichresponds with the alternative second data structure comprising thecontent. In FIG. 9 these two different second data structures areindicated by the differently dashed lines.

The selection software being present on a machine other than theauxiliary computer (103) and possibly combined with the contentrequesting software is not limited to the embodiment of FIGS. 9 and 10.In FIGS. 11 and 12, the auxiliary computer operates in a software “push”configuration. In this arrangement, content is periodically sent to theelectronic prescribing provider computer (901) by the auxiliary computer(103). When it is determined that a content transmission is appropriatein step (1201), the auxiliary computer (103) in step (1203) transmitscontent to the electronic prescribing provider computer (901). Theelectronic prescribing provider computer (901) then stores the contentin step (1205) for later retrieval on any form of storage accessible toit. When a request for content is received in step (1207), theelectronic prescribing provider computer (901) will determine if contentis available in step (1208). This content will be selected by theelectronic prescribing provider computer (901) in step (1204) to bepassed to the physician's device (800), physician's server (201), orprinter (219) in steps (1210) and (1214) or again may be sent directlyto the patient access computer (301) in step (1212). In effect, theelectronic prescribing provider computer (901) assumes the role ofauxiliary computer (103) in selecting and storing content in thisembodiment. The auxiliary computer (103) acts as a central source forcontent, but does not select content.

One benefit of these arrangements is that the auxiliary computer (103)can be freely updated with new content and the newest content willalways be selected as the particular content on the auxiliary computer(103) at the time of the request (generally in the latest update) willbe selected. Still further, this system means that the auxiliarycomputer (103) does not need to receive any confidential informationabout the patient, and no confidential information is ever transferred.Instead, the confidential information is used by existing systems whichalready handle confidential information to determine content, and theparticular piece of content is selected without need to communicateconfidential information. In a still further embodiment of thisarrangement, the selection software is combined with the contentrequesting software forming a single software entity.

These last four embodiments utilize the physician as the point ofcontact and help not only with providing information to the patient inconjunction with their prescription at a point when the prescriptionwould likely be new to the patient, but also provides information tothem at the point they are most likely to be receptive to it. Researchhas shown that people are most acutely aware of medical concerns whilethey are in the physician's office. They have often just discussedissues with the physician and have also just received advice andinformation from the physician. This advice may relate to theirprescription. Therefore, providing them with the content while they arestill with the physician can make them more receptive.

As in previously discussed embodiments, the content is principallyintended for the patient, but may be intended for use by the physicianor pharmacist to educate the patient. It is presumed that a physicianprescribing a medication will have already discussed issues related tothe medication with the patient in at least some fashion. In manyrespects, the content can memorialize the content of such discussion foreasy later reference by the patient. Further, the provided content canadd to what has already been expressed by the physician to make sure theinformation is complete.

In an embodiment, because the content is provided with the writtenprescription (the point of contact is the physician) and not thephysical medication, the content can also be geared to helping to getthe patient through their first purchase of a new medication which maybe a frightening prospect. For instance, if the prescription is for anew medication, the content may provide indications of potential sideeffects, information on medication onset, or nearby pharmacies whichshould have the medication (particularly if it is after normal businesshours and some pharmacies may not be open and the medication is clearlyintended for immediate dispensing). Further, the content may includeencouragement or information on what to expect when using the medicationand that the medication regime should commence quickly. This may help toget the patient to the pharmacist and begin a medication regimen.Further, the information may encourage a patient to use a particularbranded medication. Content may also relate specifically to whatbeginning this type of medication regimen may mean, and can againsuggest to the patient lifestyle changes which they can make to make themedication more effective or to eliminate or decrease their need for itin the future. In a prescription renewal, the content can encourage apatient to stay on the medication track, recognize a patient's success,or notify the patient of a change they need to be aware of. An exampleof content which could be distributed by a physician in any of theembodiments of FIGS. 5 through 12 is provided in FIG. 14.

In the embodiment of FIG. 14, an exemplary flyer of content for afictional cholesterol medication is shown. This content includesmarketing for the brand name “Lipizan” drug which has been prescribed.It also includes information encouraging the user to obtain themedication quickly. The content also indicates that lifestyle changesshould be made. It should be apparent that one of the lifestyle changes(regular exercise) should not be started prior to consultation with aphysician. As this content is preferably provided at the physician'soffice, the patient may be triggered by the content into discussingappropriate exercise regimens with their doctor prior to leaving theoffice.

Content may be provided for use by the physician instead of by thepatient. In this case, the content may be geared to any information ofinterest to the physician. It may include discussion points which thephysician should discuss with the patient or may include new indications(or contraindications) of the use of the medication to discuss with thepatient or even to indicate to them the prescription should not begiven. This may be due to recalls, drug interactions, or even concernsthat the patient will abuse the medication. It could also provide forupdated data with regards to drug interaction or other information whichmay have changed since the physician would have last prescribed themedication to insure the doctor knows of recent changes or discussionsof other medications which the physician may wish to consider alsoprescribing to improve a patient's chance of success.

In addition, to encourage filling of the prescription and prescriptionprovision, the content can also be used in conjunction with sampledistribution of the prescribed medication. While medication samples area popular and effective method for providing quick relief to manyindividuals which may not be able to fill a prescription right away ormay need only a limited supply, they are often problematic as there isoften no fixed literature distribution with a sample. When prescribing amedication or simply when providing a limited sample, the first datastructure may include indications that samples were provided (and howmany). In this case, the physician takes on part of the role of thepharmacist. The content provided in this situation may be specificallygeared to making sure that the patient understands the samples they havereceived and how to use them as well as how to get the associatedprescription filled if one is provided.

This type of patient contact is further useful if the prescription isnot filled shortly after it is made. If the physician provides a 5-daysample, and after 6 days the prescription has not been filled, thepatient may receive content indicating they should contact theirphysician as they may not be taking the medication correctly or remindthem to fill the prescription. This system further provides for improvedcontrol for potentially dangerous medication samples being used forillicit purposes. Further, it provides for physician follow up in casethere is a misunderstanding related to the medication.

In another embodiment of the invention, contact as discussed previouslyis combined. In the above-described embodiments of FIGS. 1 through 12,the patient only received content at one of the pharmacy or thephysician. In the embodiment of FIG. 13 the systems of the priorembodiments may be combined into an integrated communication systemwhereby the pharmacy computer (101), physician's computer (201) andpatient access computer (301) are all interlinked via the Internet tothe auxiliary computer (103). In this embodiment, the patient may beprovided with information when they initially receive their prescriptionaccording to the embodiment of FIG. 6. This information may then beintegrated with information when they pick up and refill theprescription at the pharmacy computer (101) or at the patient accesscomputer (301) before, during, or after those communications.

While the embodiment of FIG. 13 shows only a single pharmacy computer(101) and a single physician's server (201), multiple of these machinesmay be interconnected to the single auxiliary computer system (103). Anelectronic prescribing provider computer (901) may also be includedbased on the embodiment of FIGS. 8-12. In this type of system, a steadydialogue can be maintained between the patient and the auxiliarycomputer (103). Further, the system can recognize that some changes maybe indicative of a need to update information. For instance, if thepatient suddenly fills two prescriptions in a different state, thesystem may be able to ask if the patient has recently moved. Further,such an integrated system can provide notice of when a prescription maybe being abused because the same prescription is being duplicativelyfilled in multiple locations. Further, while the embodiment of FIG. 13presumes direct contact between the pharmacy computer (101), physiciancomputer (201), and auxiliary computer (103), any of the arrangements ofthe other embodiments could be used in an alternative embodiment.

As should be clear from the above discussed embodiments of the system,the content provided will depend on the particular embodiment of thesystem. In an embodiment, the content will be provided commercially aspart of a paid activity by the medication provider. In particular, thecontent will include commercial information and may relate to theprescription medication being purchased (such as for products for usewith the prescription), other medications or products (whetherprescription, OTC, or any other products) that a particular patientmight be interested in based on the prescription medication beingpurchased, or any other type of advertising for products and services.The embodiment of FIG. 14 includes commercial content as well as othercontent which might be provided in a physician's office. This commercialinformation can both provide for advertising to the patient and canencourage a patient to select one branded medication over another. Thiscan help the medication manufacturer to improve sales. As such, a systemis valuable to the medication supplier. The auxiliary computer (103) maytherefore be able to operate by payment for supplying commercialinformation in conjunction with non-commercial information.

In an embodiment of the invention, the content can also provide for anerror checking function related to the distribution of medication. Inparticular, the second data structure will generally not includeconfidential information of the patient. The auxiliary system willgenerally not provide as part of the second data structure anyconfidential information. In this way, the system cannot be abused bycalling up or providing records that a patient has not been given accessto. The system, however, will select content it is believed appropriateto the patient. If this content is illogical to the patient, the patientmay contact the physician or pharmacy to insure that the prescriptionwas correct. In this way, the patient may recognize a mistake withoutthe mistake revealing another's confidential information.

For instance, if content was provided discussing the decreased dosage ofmedication being prescribed, the patient may question their physician ifsuch decreased dosage is correct if they were not expecting the dosageto be decreased. Further, if content discussed treatment or lifestylechanges for conditions that the patient does not have, the patient maydouble check with the pharmacy or physician that the prescribedmedication is correct. Further, if the patient received reminders torenew a prescription before they ran out of pills, they may check withtheir physician if the medication is being taken correctly or with thepharmacy to determine if the medication was dispensed in the correctamount. While this error checking function is not exact, it is one morepath of dialogue to help the patient with their medications.

Further, while the above described embodiments relate specifically to anauxiliary computer (103), pharmacy computer (101), physician's computer(201), patient access computer (301) e-pharmacy computer (401), andelectronic prescribing provider's computer (901) sending information viathe Internet using packetized or other transfer of data, it should berecognized that communication technology is changing quickly and otherembodiments may utilize alternative data transmission structures,protocols, and networks for transmission as they become available.Further, in another embodiment, the auxiliary computer (103) may providenotice to a human working with the auxiliary computer (103) to contactthe patient. This may occur via mail, voice transmission, or any otherform of communication. This may be particularly desirable where thereare concerns for a patient's potential misunderstanding of aprescription medication, or urgent safety messages.

While the invention has been disclosed in connection with certainpreferred embodiments, this should not be taken as a limitation to allof the provided details. Modifications and variations of the describedembodiments may be made without departing from the spirit and scope ofthe invention, and other embodiments should be understood to beencompassed in the present disclosure as would be understood by those ofordinary skill in the art.

The invention claimed is:
 1. A system for generating information for apatient at a physician's office the system comprising: a physician'sdevice, said physician's device being in communication with aphysician's server forming a physician's network, said physician'snetwork being attached to a network; an electronic prescribing providercomputer also attached to said network and capable of receivinginformation from said physician's network; content requesting softwarerunning on at least one of said physician's server or said electronicprescribing provider; and an auxiliary computer located at a positionremote from said physician's network and said electronic prescribingcomputer and connected to said physician's network and said electronicprescribing computer by said network, said auxiliary computer includingselection software running thereon; wherein information about saidprescription and said patient is entered into said physician's device togenerate a prescription for said patient; wherein said physician'sdevice transfers said prescription and patient information to at leastone of said physician's server or said electronic prescribing providerwith content requesting software running thereon; wherein said contentrequesting software forms a first data structure including at least aportion of said patient and prescription information and transmits saidfirst data structure to said auxiliary computer via said network;wherein said selection software receives said first data structure andfrom at least a portion of said first data structure selects content forsaid patient; wherein said selection software sends a second datastructure to a least one of said electronic prescribing providercomputer, said physician's server, or said physician's device, saidsecond data structure being indicative of said content; wherein saidcontent is received by at least one of said physician or said patientprior to said patient receiving said prescription.
 2. The system ofclaim 1 wherein said information about said prescription and saidpatient includes at least one of the following types of information:National Drug Code (NDC); patient's age, patient's gender, patient ID,patient contact information, diagnostic code, physician identifier, orprior patient behavioral data.
 3. The system of claim 1 wherein saidsecond data structure indicative of said content is also electronicallytransmitted to a patient access computer.
 4. The system of claim 1wherein said content is provided to a patient in conjunction with saidprescription.
 5. A system for providing patient communicationcomprising: a physician's device, said physician's device being incommunication with a physician's server, forming a physician's network,said physician's network being attached to a network; an electronicprescribing provider computer also attached to said network and capableof receiving information from said physician's network; a patient accesscomputer whereby a patient can obtain information, said patient accesscomputer also attached to said network; a pharmacy computer alsoattached to said network; content requesting software running on atleast one of said physician's server, said electronic prescribingprovider, or said pharmacy computer; and an auxiliary computer locatedat a position remote from said physician's network, said electronicprescribing computer, said patient access computer and said pharmacycomputer and connected to physician's network, said electronicprescribing computer, said patient access computer and said pharmacycomputer by said network, said auxiliary computer including selectionsoftware running thereon; wherein said content requesting software formsa first data structure and transmits said first data structure to saidauxiliary computer via said network; wherein said selection software onsaid auxiliary computer receives said first data structure from saidcontent requesting software and selects content for said patient from atleast a portion of said first data structure; and wherein said auxiliarycomputer supplies a second data structure being indicative of saidcontent to at least one of said physician's device, said physician'sserver, said electronic prescribing provider computer, said patientaccess computer, or said pharmacy computer.